IRMAA is the Medicare surcharge most retirees don't see coming. It adds hundreds to thousands per year to Medicare costs for higher-income beneficiaries — and it's based on income from two years ago, which means decisions you made in 2024 affect what you pay in 2026.
What Is IRMAA?
IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge added to Medicare Part B and Part D premiums when your Modified Adjusted Gross Income (MAGI) exceeds certain thresholds. The surcharge is determined by the Social Security Administration using IRS income data from your tax return two years prior — your 2024 return determines your 2026 IRMAA.
2026 IRMAA Brackets — Single Filers
| 2024 MAGI (Single) | Monthly Part B | Part D Surcharge | Annual Extra Cost |
|---|---|---|---|
| $0 – $109,000 | $202.90 | $0 | $0 |
| $109,001 – $137,000 | $284.10 | +$14.50 | +$1,147/yr |
| $137,001 – $163,000 | $356.00 | +$37.60 | +$2,288/yr |
| $163,001 – $194,000 | $427.90 | +$60.40 | +$3,425/yr |
| $194,001 – $500,000 | $499.90 | +$83.90 | +$4,528/yr |
| Over $500,000 | $689.90 | +$91.00 | +$6,935/yr |
2026 IRMAA Brackets — Married Filing Jointly
| 2024 MAGI (Joint) | Monthly Part B (per person) | Part D Surcharge (each) |
|---|---|---|
| $0 – $218,000 | $202.90 | $0 |
| $218,001 – $274,000 | $284.10 | +$14.50 |
| $274,001 – $326,000 | $356.00 | +$37.60 |
| $326,001 – $388,000 | $427.90 | +$60.40 |
| $388,001 – $750,000 | $499.90 | +$83.90 |
| Over $750,000 | $689.90 | +$91.00 |
The Cliff Effect — Why $1 Can Cost You $974
IRMAA is a cliff system, not a gradual increase. A single filer with 2024 MAGI of $109,000 pays $202.90/month. A single filer with $109,001 pays $284.10/month — $81.20 more per month, $974 more per year, for $1 of additional income. This cliff effect makes income planning in the years leading up to Medicare enrollment particularly important.
Common IRMAA triggers to plan around: Large Roth conversions, capital gains from selling a home or investment, Required Minimum Distributions (RMDs), Social Security income becoming taxable, pension lump-sum distributions, and inheritance income can all push MAGI across a bracket threshold.
How to Appeal IRMAA — SSA Form SSA-44
If your income dropped significantly after the determination year due to a qualifying life-changing event, you can appeal IRMAA using SSA Form SSA-44. Qualifying events include:
- Retirement or reduction in work hours
- Death of a spouse
- Divorce or annulment
- Marriage
- Loss of income-producing property (involuntary)
- Loss of pension income
- Employer settlement payment received
A one-time income event — selling a home, a large Roth conversion — does not qualify as a life-changing event for IRMAA appeal purposes. Only ongoing income changes qualify.
To appeal: complete SSA-44, attach supporting documentation (tax return, pay stubs, retirement letter), and submit to your local Social Security office. If approved, Medicare recalculates your premium using more recent income data.
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